[The effects of alcohol management programmes for pregnant women]

by



ACKNOWLEDGEMENT

I would take this opening to express gratitude my study supervisor, family and associates for their support and guidance without which this study would not have been possible.

DECLARATION

I, [type your full first titles and last name here], declare that the contents of this dissertation/thesis represent my own unaided work, and that the dissertation/thesis has not previously been submitted for learned examination in the direction of any qualification. Furthermore, it represents my own attitudes and not inevitably those of the University.

Signed __________________ Date _________________

ABSTRACT

Objective: To present a systematic review on the effects of alcohol management programmes for pregnant women and recording of alcohol use and counselling on alcohol use of women of child-bearing age and pregnant women based on the most up-to-date evidence.

Evidence: Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library in May 2009 using appropriate controlled vocabulary (e.g., pregnancy complications, alcohol drinking, prenatal care) and key words (e.g., pregnancy, alcohol consumption, risk reduction). Results were restricted to literature published in the last five years with the following research designs: systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to May 2010.

Grey (unpublished) literature was identified through searching the websites of health technology assessment (HTA) and HTA-related agencies, national and international medical specialty societies, clinical practice guideline collections, and clinical trial registries.

Each article was screened for relevance and the full text acquired if determined to be relevant. The evidence obtained was reviewed and evaluated by the members of the Expert Workgroup established by the Society of Obstetricians and Gynaecologists of Canada. The quality of evidence was evaluated and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care.

Values: The quality of evidence was rated using the criteria described by the Canadian Task Force on Preventive Health Care.

Sponsor: The Public Health Agency of Canada and the Society of Obstetricians and Gynaecologists of Canada.

Endorsement: These consensus guidelines have been endorsed by the Association of Obstetricians and Gynecologists of Quebec; the Canadian Association of Midwives; the Canadian Association of Perinatal, Women's Health and Neonatal Nurses (CAPWHN); the College of Family Physicians of Canada; the Federation of Medical Women of Canada; the Society of Rural Physicians of Canada and Motherisk.

TABLE OF CONTENTS

ACKNOWLEDGEMENTII

DECLARATIONIII

ABSTRACTIV

LIST OF ABBREVIATIONS1

CHAPTER 1: INTRODUCTION2

Introduction2

Problem Statement3

Background of the Research3

Aim of the Research4

Research Objectives4

Research Question5

SR Protocol5

Outline of the Study7

CHAPTER 2: LITERATURE REVIEW8

Alcohol Content8

Typical alcohol by volume levels are:8

Standard Drink8

Low-risk Drinking9

Binge Drinking9

Why Alcohol Use Is a Problem and Why Guidelines Are Required15

Intended or Unintended Pregnancy19

Recognition, Screening, and Documentation20

Selected Factors Associated with Alcohol Use Among Pregnant Women and Women of Child-bearing Age34

Counselling and Communication With Women About Alcohol Use37

CHAPTER 3: METHODOLOGY44

Research Design44

Titles and Abstracts44

Research Strategy45

Research Approach45

Data Extraction Strategy46

Databases47

Keywords47

Qualitative Data Analysis48

Systematic Review Process48

Rationale for Systematic Review48

Strengths of Systematic Reviews49

Limitations of Systematic Review49

Data Synthesis50

Ethical Consideration50

Validity50

CHAPTER 4: CRITICAL ANALYSIS AND DISCUSSION53

Significant difference in findings53

CHAPTER 5: CONCLUSION70

REFERENCES73

List of Abbreviations

ARND alcohol related neurodevelopmental disorder

AUDIT ...